ROLE OF FIBEROPTIC BRONCHOSCOPY IN SPUTUM NEGATIVE PATIENTS

Abstract

Background:Tuberculosis continues to be the one of the most common global health problems for more than a century. Fiberoptic bronchoscopy may be very useful in diagnosing cases who have no sputum or whose sputum smear is negative for Acid-Fast bacilli. The current study aims to assess the role of fiberoptic bronchoscopy in sputum smear negative under NTEP and radiologically suspected cases of pulmonary tuberculosis. Methods:This study was conducted in our institution in clinico-radiological suspected cases of pulmonary tuberculosis patients in whom two sputum smear for acid fast bacilli by Zeihl-Neelsen stain under NTEP was negative. Fiberoptic bronchoscopy was performed in all these patients and samples taken were sent for investigations. Result:Fiberoptic bronchoscopy was performed in a total of 110 patients of presumptive pulmonary tuberculosis whose sputum for AFB smear was negative. Out of 110 patients, 65.45% were male and 35.55% were female. Fever was the most common presenting symptom and was found in 93.64% patients. Radiographically, pulmonary consolidation was bilateral in 63.34% cases while was unilateral in 36.36% cases. The total yield of FOB came out to be 59.1% in which BAL for AFB smear was positive in 43.63% cases, BAL for Mtb culture was positive in 54.54% cases while, BAL for PCR was found to be positive in 59.09% cases. Conclusion:Fiberoptic bronchoscopy may be useful in rapid diagnosis and early treatment initiation thereby, reducing the risk of transmission of the disease. The findings of the study indicated that fiberoptic bronchoscopy is a useful method to diagnose the cases of sputum negative radiologically suspected symptomatic patients of tuberculosis.